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대장암 환자에서 복막 전이에 대한 복수내 암태아 항원(Carcinoembryonic Antigen)의 진단적 가치

Diagnostic Value of Carcinoembryonic Antigen in Ascites for Colorectal Cancer with Peritoneal Carcinomatosis

대한소화기학회지
2018년 71권 6호 p.332 ~ p.337
송성은 ( Song Sung-Eun ) - 고신대학교 의과대학 내과학교실

최바울 ( Choi Pa-Ul ) - 고신대학교 의과대학 내과학교실
김재현 ( Kim Jae-Hyun ) - 고신대학교 의과대학 내과학교실
정경원 ( Jung Kyoung-Won ) - 고신대학교 의과대학 내과학교실
김성은 ( Kim Sung-Eun ) - 고신대학교 의과대학 내과학교실
문원 ( Moon Won ) - 고신대학교 의과대학 내과학교실
박무인 ( Park Moo-In ) - 고신대학교 의과대학 내과학교실
박선자 ( Park Seon-Ja ) - 고신대학교 의과대학 내과학교실

Abstract

Background/Aims: Diagnostic tests for carcinoembryonic antigen (CEA) in ascites have been performed in various malignant cases, but there is only few data on the applicability of CEA for colorectal cancer (CRC) patients with peritoneal carcinomatosis. We aimed to determine the usefulness of CEA in ascites (aCEA) as a diagnostic parameter for CRC with peritoneal carcinomatosis.

Methods: Between January 2000 and May 2013, the medical records of 259 patients who underwent paracentesis for the evaluation of ascites were retrospectively reviewed. CRC patients with ascites (n=82) and patients with non-malignant ascites (n=177) were evaluated. Patients who had other malignancies, including gastric or ovarian cancer, with ascites were excluded. The optimal diagnostic cut-off value of aCEA for CRC with peritoneal carcinomatosis was determined using receiver operating characteristic curve analysis. The value of aCEA for predicting the occurrence of peritoneal carcinomatosis was evaluated using a logistic regression model.

Results: The optimal cut-off value of aCEA to diagnose CRC with peritoneal carcinomatosis was 3.89 ng/mL, and the area under the curve for aCEA was 0.996 (sensitivity 96.3%, specificity 100%, positive predictive value 100%, negative predictive value 98.3%). Multivariate logistic regression analysis showed that aCEA was an independent factor predicting the occurrence of peritoneal carcinomatosis.

Conclusions: In this study, we showed that aCEA may be a useful parameter for diagnosing CRC with peritoneal carcinomatosis, and we propose an optimal aCEA cut-off value of 3.89 ng/mL. Further study that includes patients with other malignant ascites may be necessary to validate these findings.

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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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